Pressures of hypertension

High blood pressure is increasing

Medical experts may not agree on the exact prevalence of hypertension among older South Africans, but there was one simple message from researchers and the government alike: too many over the age of 50 have high blood pressure.

The concern expressed extends to the fact that many sufferers are unaware of their condition, putting them at increased risk of heart disease, stroke and dementia.

A recent study found that 78% of South Africans over the age of 50 have high blood pressure. This is the highest rate reported for "any country in the world at any time in history", according to its authors.

Less than one in 10 of these people were effectively controlling their hypertension with medication. The data was drawn from a Study on Global Ageing and Adult Health, conducted by the World Health Organisation.

The study surveyed more than 35,000 people aged 50 and older in S A, China, Ghana, India, Mexico and Russia. The lowest rate of high blood pressure (32%) was recorded in India.

"High blood pressure is not a disease of the privileged ; it affects rich and poor, old and young, men and women," said lead author Peter Lloyd-Sherlock, professor of social policy and international development at the University of East Anglia.

The study found the biggest risk factor of having high blood pressure was being overweight or obese and in South Africa 72% of men and women over the age of 50 fell into one of these categories. In India, just 12.7% of the respondents were overweight or obese.

"In many countries, public awareness about hypertension remains very low," said Prof Lloyd-Sherlock. "The condition is not prioritised by national governments or development agencies.

"Unless this changes, avoidable deaths and disability resulting from hypertension are set to soar. Ideally, we should persuade people to adopt healthier diets and lifestyles, but in the short run we should at least ensure they have access to effective treatment."

But the data in the IJE study is at odds with previously published research, which found significantly lower prevalence of high blood pressure among older South Africans, according to the health department’s head of non-communicable diseases Melvyn Freeman. "We are somewhat dubious of the figures because they are a lot higher than other studies are suggesting," he said.

"It is not clear how they came to these results. But … it doesn’t mean we are not worried.

"Clearly, there is a problem of severe magnitude. We have been taking action to reduce hypertension with a number of initiatives."

Prof Freeman cited programmes to regulate the salt content of processed food and encourage people to get tested for hypertension as part of its HIV counselling and testing campaign as some of the initiatives.

Prof Freeman said the 2008 National Income Dynamics Study found high blood pressure among 50% of men aged between 45 and 54, 70% of men aged between 55 and 64, and 78% of men aged over 65. For women, the figures were 50%, 63% and 71% in the corresponding age groups.